Living well

Although memory problems can be very upsetting for those affected and for the people around them, there are a number of strategies that you can put in place to help you minimise the impact of memory problems.

The most important thing to do is not get too worried about your memory problems. Lots of people have memory problems but live happy and contented lives.

Here are some helpful tips on coping with some common difficulties that people encounter.

Tips for remembering to do things

• Carry a notebook. Write down the things you have to do when they come into your mind. Once you have carried out a task, cross it off the list. You could use a dictaphone or smartphone in a similar way.
• Keep a diary calendar or electronic calendar. Write down appointments on the correct page as soon as you receive them. Check your diary every morning and at several times throughout the day
• Use a memo-board/white board, or ‘post-it’ notes. Write down tasks when you think of them and remove notes once done. You could put ‘post-it’ notes in prominent positions, e.g. ‘REMEMBER KEYS!’ and get into the habit of looking at them regularly.
• Use an electronic motion sensor 'Memo minder' to help remind you of things in certain places in the house
• Consider using reminders on mobile phones/computers/tablets or use the apps and calendars on smartphones.
• Follow structured routines for everyday tasks – like taking your tablets. Write down the routine and keep it somewhere you will see it easily. You can buy medication pill boxes with the days of the week and time of day written on them to help you remember to take tablets correctly. You can also speak to your GP about arranging a medication dosette or dispensary box. Or speak to your local telehealth team via the Social Care Team about an electronic pill dispenser.
• Use an alarm watch, mobile phone or electronic organiser to remind you when to do things. In both cases when the alarm goes off, a message will be displayed.

Tips for remembering where to put things

• Put things in the same place (‘a place for everything and everything in its place’). Concentrate for a few seconds on the place where each thing has been put. Say out loud what the item is and where it is - try to create a visual image of the object and where it is in your mind.
• You could stick labels on cupboards, drawers, doors etc, telling you what items can be found where. Use see-through containers for some items
• Attach string to keys and tie this to your belt hook or in your pocket. Attach a chain or cord to your glasses to wear around your neck. Consider using a tracker device in a wallet/purse, on phones and on keys to help to find lost items. Using keyring attachments to attach your phone and wallet to the bag can also be useful or making sure they’re all the same colour to help you search quickly for them. 
• Write all important phone numbers in large writing on a piece of paper and stick them on a wall by the phone. You can also program important numbers into the telephone using ‘speed-dial’. In addition, put a list of them in your diary and your notebook. Alternatively streamline your phone and leave only your key numbers in the phone to simplify it.
• When you are going out, carry your things in a single bag. If this isn’t possible, count how many items you have and check regularly that you have the same number of items throughout your trip. Keep all of your things in front of you so you can see them. Consider using a bag with a lighter coloured lining to make it easier to see and find items.

Tips for remembering where you are going

• Try to make sure you always use the same route and try to be aware of your surroundings on this route. Look for landmarks. Are there churches, pubs, schools you pass on the way? Say a route to yourself as you walk. For example, ‘I walk down the street, turn left at the pub, cross the road by the church and I’m at the shops’. Consider also using a map on a smart phone to guide you. The map can either show you or speak out loud the directions for you.
• Take a phone number of a close friend or relative with you if going somewhere unfamiliar, so you can get directions if you get lost. Write down directions before you go or ask someone else to write them down for you. You could also put your name and address onto iron-on labels inside your jacket or coat.
• Write down directions you get in a notebook as you are told them or speak them into a dictaphone.
• Don’t be embarrassed at having to ask the person to repeat themselves or to slow down if you have not quite understood. Very few people understand directions the first time they hear them.
• If you live with other people, it may be helpful for them if you leave a note to say where you are going.
• If you often get lost and you need help with navigation or your family/friends want to know where you are to have peace of mind consider using smartphone apps to help locate where you are or consider tracking devices. Your local council may even be able to rent you one if you contact their careline team.
• Even if navigating where you are going isn’t a difficulty, we would advise putting a GPS app on your phone or finding a GPS gadget to avoid any problems.
• Look back at where you have come from to help orientate yourself when getting up to go to the toilet in a restaurant or cafe or leaving a parked car.

Tips for having conversations
Many people feel embarrassed by their memory problems. They are afraid to look silly in front of others. Some people cope with this by withdrawing from conversations or social events. This is not helpful and often makes people feel more anxious, less confident, and lonely and depressed in the long run.

• To help remember someone’s name, repeat it during conversation or ask them to spell it. Say their name again when you say goodbye – all this repetition helps us learn! Go through the alphabet and if you come across the first letter of their name this might help you get the rest of it.
• If you can’t remember it, don’t worry: lots of people forget names, just concentrate on the conversation
• If you are lost in a conversation, tell the person you have a few memory problems and ask them to recap. Many people have memory lapses so they are likely to understand.
• If you can’t remember the name or word for something, describe to them what you mean – people will often know what you are referring to.
• Write down important messages or conversations – using bullet points can help to keep it simple.
• Paraphrase conversations or things people have told you - saying it back to someone helps you encode the information better.
• If your speech has been affected by your dementia and you are struggling with having conversations speak to your healthcare professional about speech and language therapy services in your area.
• A useful charity to consider looking for support is: Dyscover who provide support/opportunities for with people who have speech difficulties and their families.
• Take a few moments before going out to remember the names or everyone you are meeting and any key family/friends you often ask after. Scrolling through your phone messages or emails can be a useful way to recap these.  

It is important to make sure you take good care of your physical and mental health. Always check with your doctor if you feel unwell. Having dementia should not mean that you feel ill. It is important that you have regular eyesight, hearing and dental checkups. Being worried, and feeling low or unwell can affect your ability to cope with dementia, so talk to your GP about this.

Medication                                                                             
If you are on tablets, ask your GP to check whether they are essential. Some medicines have side effects, which can add to the symptoms you are already experiencing. Make sure you take your tablets at the right time and the right dose. There are aids available to help you remember when to take your tablets. One example is a box for your tablets with separate compartments for each day of the week, sometimes called dossett boxes. Your GP can also arrange for your medication to be delivered to you in blister packs which can make it much easier to manage. Surrey and Hampshire Telecare can provide pill dispensers which remind you when to take pre-measured doses by sounding an alarm. Hampshire County Council offer similar technology too.

Diet
It is important to maintain a healthy weight. Being overweight can affect mobility and also increase the risk of other medical conditions such as diabetes or heart disease. Most people need fewer calories as they age – this is because the metabolism slows with age and people generally become less active. However, it is also important to ensure that you are not underweight and that you are getting all the nutrients you need. Eating too little or missing out on essential nutrients will reduce resistance to illness and may cause confusion. If you have difficulty with preparing regular, healthy meals you may find it helpful to use ready meals or “Meals-on-Wheels”or another online delivery service.

A healthy balanced diet reduces the risk of coronary heart disease, strokes, some cancers and diabetes. With vascular dementia, diet and lifestyle play an important role in preventing further strokes or TIAs (Transient Ischemic Attacks, often referred to as 'mini strokes'). There is also increasing evidence that certain food types are essential for memory and brain function. You can find information about a healthy diet on the Alzheimer's Society website or ask a member of your team to provide you with some.

Further advice on how to manage your weight can be found on here: One You Surrey website

Drinking
It is important that you drink plenty of fluids to keep your body hydrated. There is an increased risk of confusion as a result of dehydration. You do not have to restrict yourself to drinking water – any hot or cold liquids will keep you hydrated. Be aware that any drinks that have caffeine in could affect your sleep which could in turn affect your memory.  

Alcohol
Too much alcohol can cause confusion and dehydration. Alcohol can also interact with certain medications. If you have a type of dementia related to alcohol use it is very important not to drink alcohol because it may make symptoms worse. Check with your doctor whether it is advisable for you to drink alcohol.

Men and women are advised not to regularly drink more than 14 units of alcohol a week. Spread your drinking over three days or more if you drink as much as 14 units a week.

A measure of a single spirit with a mixer contains one unit of alcohol. A standard glass of wine or a pint of regular lager both contain 2.3 units.

Exercise
Exercise is important for both a healthy body and mind. It can also help to reduce stress and tension. It is important to find something that you enjoy.

Consider joining a Keep Fit or Pilates class at your local leisure centre or YMCA. Many day centres also offer exercise classes for those who have mobility difficulties.

You do not have to take on anything strenuous – walking is a great way of getting some gentle exercise as well as fresh air.

Useful resources:

Active Surrey
Walking for Health
Parkrun

If you are on Personal Independent Payments from you local council you can consider using these to pay for exercise opportunities.

Relaxation
It is crucial that you take time to relax, particularly during times of stress. Often when people are going through a difficult time they cut down on activities that they enjoy. This is the last thing you should do as it can lead to low mood and an increase in stress. If you do feel that you are doing too much try to cut down on activities that are stressful or draining, but keep up the ones you enjoy. If you are finding it difficult to keep up with the activities you used to enjoy you may need to think about developing new hobbies or interests. If you find it very difficult to relax, it can help to practice relaxation and breathing techniques. Talk to a healthcare professional for more advice about this.

Social activity
While it is important to take time out for yourself to relax, it is equally important to maintain an active social life. This can be difficult if you are worried about what other people might think of your diagnosis, or if you are anxious about being in social situations.

It is important to remember that others can be a great source of support during this time. And don’t forget - you still have a lot to offer others. Try to keep up contact with your circle of friends and be open to making new friends.

Here is a list of activities to consider that you may enjoy. Not all of these activities will appeal to everyone of course, but we hope that this will provide you with ideas of activities you could try.

This list has been adapted from a tool called The Pleasant Events Schedule designed by two psychologists in the USA: Linda Teri and Rebecca Logsdon. The list was originally devised for people with Alzheimer’s disease but can also be useful for people with other types of dementia.

• Being outside (sitting outside, being in the country)
• Meeting someone new or making new friends
• Planning trips or holidays, looking at travel brochures, travelling
• Shopping, buying things (for self or others)
• Being at the beach
• Listening to music (radio, CDs)
• Watching TV
• Camping
• Thinking about something good in the future
• Completing a difficult task
• Laughing
• Doing jigsaw puzzles, crosswords, and word games
• Having meals with friends or family (at home or out)
• Getting/sending letters or cards
• Watching the clouds
• Going on outings (to the park, a picnic, a barbeque, etc)
• People-watching
• Having coffee, tea, a drink, etc with friends
• Reading or listening to stories, novels, plays or poems
• Being complimented or told I have done something well
• Being told I am loved
• Reading, watching, or listening to the news
• Having family members or friends tell me something that makes them proud of me
• Seeing or speaking with old friends (in person or on the telephone)
• Looking at the stars or moon
• Playing cards or games
• Doing handiwork (crocheting, woodworking, crafts, knitting, painting, drawing, ceramics,
• clay work, etc.)
• Exercising (walking, aerobics, swimming, dancing, etc.)
• Taking a shower or bath
• Being with animals or pets
• Listening to non-music radio programmes (talk shows)
• Making or eating snacks
• Helping others, helping around the house, dusting, cleaning, setting the table, cooking
• Combing or brushing my hair
• Taking a nap
• Being with my family (children, grandchildren, siblings, others)
• Watching animals or birds (in a zoo or in the garden)
• Wearing certain clothes (such as new, informal, formal, or favourite clothes)
• Listening to the sounds of nature (birdsong, wind, surf)
• Having friends come to visit
• Going to museums, art exhibits, or related cultural activities
• Looking at photo albums and photos
• Stamp collecting, or other collections
• Sorting out drawers or cupboards
• Going for a ride in the car
• Going to church, attending religious ceremonies
• Singing
• Grooming self (wearing makeup, having hair done)
• Going to the movies (www.ceacard.co.uk)
• Recalling and discussing past events
• Participating in or watching sports (cricket, bowls etc).
• Indoor gardening or related activities (e.g. tending pot plants)
• Outdoor gardening or related activities (mowing lawn, raking leaves, watering plants etc.)

Receiving a diagnosis of dementia often leads to initial feelings of shock, disbelief and denial. Sometimes denial can be a good thing and help you to cope with the reality of having dementia at your own pace.

Other feelings you may experience are:
Fear: often the biggest fear is loss of control. Not knowing what is going to happen to you can be very frightening. Other common fears include: becoming a burden to one’s family,
fear of financial instability, passing your condition onto your children and fear of physical deterioration in the future.
Guilt: you may think that you have done something wrong or not tried hard enough to prevent the disease. You may even feel that you are to blame. Be assured that dementia is an organic disease. Whatever type of dementia you have, it is not your fault.
Sense of loss: you may feel sad that you will not be able to do some of the things that you had planned to do, or that you have to stop doing things you enjoy.
Relief: you may feel relieved that you now have a medical explanation for the changes in thinking and behaviour that you have been experiencing. 
Acceptance: you may never fully accept your illness, but this is okay. You will find a way of living with it.

Managing your feelings
Be kind to yourself
Above all it is important to be kind and compassionate to yourself. Do not criticise or blame yourself
when you make mistakes – remember that these problems are not your fault. You are facing some difficult challenges and you need to give yourself credit for this.
Talking helps
If you can, talk to your friends and family about your worries. Don’t bottle things up. You may find that you only want to talk to your close family, or it may be difficult talking to those closest to you. Thinkabout joining a support group. Many  people with dementia find it useful to speak to other people in
the same situation. Your local Alzheimer’s Society branch will be able to help you with this.

Stay as active as you can
It is important to stay as physically and socially active as you can. Keep doing the hobbies you enjoy and seeing your friends as much as possible.

Try to focus on what you can still do, rather than on what you can’t. Physical exercise can also be very helpful in lifting your mood and taking your mind off your worries.

Plan for the future
Think about what you may need in times ahead and plan for your future. Knowing that you have a say in what happens in future events might alleviate some of your anxiety.

Make a record
Sometimes writing your feelings down can help. You may also want to consider starting a life history book. Use a simple scrapbook or photo album to record details of your past and present life that will be helpful for anyone who may be supporting you.

This is something your family and friends can help you with, and it is a great opportunity to share your history, memories and thoughts with those close to you.

Getting professional help

If you are feeling overwhelmed by difficult feelings, it is important to ask for help. Talk to your GP or other health care professional about what support is available to you. This may include psychological therapy, Occupational Therapy (OT), Speech and Language Therapy, complimentary therapies or medication.

You can find more information about Psychological Therapies, Occupational Therapy and Cognitive Rehabilitation on our Support we offer page

Speech and Language Therapy

Speech and language therapists can offer help and advice on language, communication, information processing, memory, as well as eating, drinking and swallowing guidelines. Speech and language therapy can include assessment and advice as well as support for the individual and their family.

Complementary therapies
Although complementary therapies will not cure dementia, they can help to reduce anxiety and agitation. NICE (National Institute for Health and Excellence, which provides guidance to the NHS on evidence-based treatments) suggests that people with dementia may benefit from:

• aromatherapy
• massage
• music/dance therapy
• animal-assisted therapy

We do not offer these services but talk to your GP to find out how you might be able to get access to these treatments.

Medication
In some cases your doctor may consider prescribing medication to treat depression or anxiety. These can be really helpful in taking ‘the edge off’ your distress.